Individual
ZELALEM TAYE MENGISTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 981-7000
(540) 853-0931
Mailing address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 981-7000
(540) 853-0931
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101251365
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/02/2008
Last updated
07/08/2021
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